抑郁症状对腰椎融合术结局的影响——一项为期 5 年的随访研究。
Influence of Depressive Symptoms on the Outcome of Lumbar Spine Fusion-A 5-year Follow-up Study.
机构信息
Department of Orthopedics and Traumatology, Tampere University Hospital, Tampere, Finland.
Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland.
出版信息
Spine (Phila Pa 1976). 2021 Mar 15;46(6):408-412. doi: 10.1097/BRS.0000000000003803.
STUDY DESIGN
Prospective follow-up study.
OBJECTIVE
The aim of this study was to assess whether depressive symptoms change the outcome of lumbar spine fusion (LSF) surgery at a 5-year follow-up.
SUMMARY OF BACKGROUND DATA
Previous reports of the influence of depressive symptoms on the results of spine surgery are controversial, but the patient characteristics and indications for surgery varied widely between the studies. The influence of depressive symptoms on the 5-year outcome of LSF has not been studied.
METHODS
The study was based on data from a local LSF database from two hospitals comprising 392 consecutive patients (mean age 61 years, 277 women) who underwent an instrumented LSF and fulfilled the 5-year follow-up. At the 5-year follow-up, the patients were compared with a control group from the general population (n = 477, age-, sex-, and residential area-matched) extracted from Official Statistics of Finland. The prevalence of depressive symptoms was evaluated using the Depression Scale (DEPS; 0-30) and disability was evaluated by the Oswestry Disability Index (ODI; 0-100%). A DEPS score ≥12 was considered to indicate depressive symptoms.
RESULTS
Before surgery, 35% of the patients had depressive symptoms. The proportion diminished to 13% at 3 months postoperatively and increased to 24% at 5 years. In the population, the prevalence was 11% at baseline and 10% at the 5-year follow-up. The preoperative ODI was 54 in the patients with depressive symptoms, and it was 41 in the patients with no depressive symptoms. The changes at 5-year follow-up were -20 and -18, correspondingly. The same congruence was preserved when analyzing short and long fusions separately. These changes were statistically and clinically significant. In the control population, the ODI remained around 24 in depressive people and 10 in nondepressive people.
CONCLUSION
Our data suggest that patients with and without depressive symptoms may benefit equally well from LSF.
LEVEL OF EVIDENCE
研究设计
前瞻性随访研究。
目的
本研究旨在评估抑郁症状是否会在 5 年随访时改变腰椎融合术（LSF）的结果。
背景资料概要
先前关于抑郁症状对脊柱手术结果影响的报告存在争议，但这些研究中的患者特征和手术适应证差异很大。抑郁症状对 LSF 5 年结果的影响尚未得到研究。
方法
该研究基于来自两家医院的当地 LSF 数据库中的数据，该数据库包括 392 例连续接受器械性 LSF 并完成 5 年随访的患者（平均年龄 61 岁，277 例女性）。在 5 年随访时，将这些患者与芬兰官方统计数据中提取的一般人群对照组（n=477 例，年龄、性别和居住地区匹配）进行比较。使用抑郁量表（DEPS；0-30）评估抑郁症状的患病率，使用 Oswestry 残疾指数（ODI；0-100%）评估残疾程度。DEPS 评分≥12 被认为存在抑郁症状。
结果
术前，35%的患者存在抑郁症状。这一比例在术后 3 个月时降至 13%，在 5 年后增至 24%。在人群中，基线时患病率为 11%，5 年随访时为 10%。有抑郁症状的患者术前 ODI 为 54，无抑郁症状的患者为 41。5 年随访时的变化分别为-20 和-18，相应地。当分别分析短融合和长融合时，这种一致性仍然存在。这些变化在统计学和临床上均具有显著意义。在对照组中，抑郁人群的 ODI 保持在 24 左右，非抑郁人群的 ODI 保持在 10 左右。
结论
我们的数据表明，有和没有抑郁症状的患者可能同样从 LSF 中受益。
证据等级
3。
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